Proximal Fibular Osteotomy: Is it Really an Option for Medial Compartmental Osteoarthritis Knee? Our Experience at Terti
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ORIGINAL ARTICLE
Proximal Fibular Osteotomy: Is it Really an Option for Medial Compartmental Osteoarthritis Knee? Our Experience at Tertiary Centre Aamir Bin Sabir1 · Mohd. Faizan1 · Vishal Singh1 · Latif Z. Jilani1 · Sohail Ahmed1 · Ziaul Hoda Shaan1 Received: 29 July 2020 / Accepted: 7 October 2020 © Indian Orthopaedics Association 2020
Abstract Introduction The medial compartment is commonly involved in age-related osteoarthritis knee because weight-bearing axis passes close to the medial condyle and its large surface area. Various treatments have been proposed ranging from conservative to total knee arthroplasty which is an expensive and complex treatment. Recently, proximal fibular osteotomy (PFO) for medial compartment knee osteoarthritis became popular as a treatment modality. Although, the mechanism of PFO is not clear. So, we conducted a prospective study to assess the clinico-radiological outcome of proximal fibular osteotomy in medial compartment osteoarthritis knee. Materials and methods We conducted a prospective study from November 2017 to November 2019 on 32 (47 knees) patients with degenerative medial compartmental osteoarthritis knee, varus deformity 0.05). The mean pre-operative clinical and functional KSS was statistical insignificantly improved at 3 months and final follow-up (p > 0.05). The mean pre-operative lateral and mean pre-operative joint space ratio was also improved statistically insignificant (p > 0.05). Extensor hallucis longus (EHL) weakness was documented in five knees (10.6%) and paraesthesia was documented in seven (14.8%) knees. Conclusion Although, PFO is a simple, less invasive and affordable procedure, we could not reproduce the favourable results in medial compartmental osteoarthritis knee. This procedure is also associated with reversible but noticeable complications. So, we would not consider PFO as an alternative option in the treatment of medial compartmental osteoarthritis knee. Keywords Proximal fibular osteotomy · Medial compartmental osteoarthritis · Peroneal nerve palsy · VAS · Lateral FTA and KSS
* Mohd. Faizan [email protected]
Sohail Ahmed [email protected]
Aamir Bin Sabir [email protected]
Ziaul Hoda Shaan [email protected]
Vishal Singh [email protected]
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Latif Z. Jilani [email protected]
Department of Orthopaedic Surgery, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh 202002, India
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Introduction Osteoarthritis of the knee is an age-related disease which shows degeneration and regeneration (osteophytes). Knee osteoarthritis is common in developing countries like India due to lifestyle (squatting and palthi posture) which subjects the knee joint to stresses. Its prevalence in India is about 28% [1]. It initially affects the medial compartment due to larger surface area and mechanical axis passes close to the medial compartment and leads to varus deformity. Depending on the severity, the spectrum of treatment extends from conservative (analgesic, glucosamin
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